GIS 13 MA/07: UAS-NY/Care At Home I/II

The purpose of this GIS message is to advise local departments of social services (LDSS) staff of changes to the assessment procedures for the Care At Home (CAH) I/II waiver as a result of the statewide implementation of the Uniform Assessment System of New York (UAS-NY).

On March 1, 2013, the transition to the UAS-NY for eight(8) Medicaid home and community based long term care programs, including the CAH I/II waiver, began in select counties and will be phased in statewide over the course of the next twelve months. You will be advised of the required UAS-NY transition and implementation activities under a separate communication from the Department.

The UAS-NY includes two age-appropriate pediatric assessment instruments. One is for children and youth age 4 through 17 and the second is for infants and toddlers birth through age 3. These pediatric assessment instruments review multiple domains of function, health, social support, and service use.

The UAS-NY assessment instruments will be used in place of the current assessment instruments used to assess and determine Level of Care. For the CAH I/II waiver, the UAS-NY pediatric assessment instruments will replace the Pediatric Patient Review Instrument (PPRI) and Home Health Assessment Abstract (DSS 3139) as the Level of Care, and assessment/reassessment tool for applicants to, and participants in CAH I/II.

The PPRI and the HHA 3139 will continue to be used for assessment and Level of Care determination for a child applying for CAH I/II waiver enrollment who is institutionalized within a hospital or nursing facility, either in or out of state. However, once the child is enrolled in the CAH I/II waiver and residing in the community, the UAS-NY must be completed within 45 days of the child's discharge from the facility to support initial care planning activities. The CAH I/II Application Cover Sheet has been updated to reflect a check-off box (6) for the UAS-NY (attached).

It should be noted that the UAS-NY will not be used at this time for Medicaid prior approval of private duty nursing. Therefore, if the child requires this service, the assessment tools currently in use will continue to be used for this state plan service.

Because the UAS-NY is an electronic data base, the assessment information may be viewed on the Health Commerce System (HCS) by local districts, providers and others with a legitimate business need to access the information. LDSS CAH staff will obtain access to the HCS through the LDSS Health Commerce System Coordinator in his/her district. To complete an application and obtain HCS access takes two weeks. You will be notified when CAH case management agencies can begin the HCS application process. Until access is available, LDSS CAH staff will continue to use existing tools for CAH.

In certain cases, an applicant to the CAH I/II waiver may already be receiving long term care services, such as personal care through a managed care organization. In these instances, if the UAS-NY pediatric assessment was recently completed, the assessment results may be used for CAH I/II enrollment and program eligibility determination providing that:

• the child's condition has not changed from when the assessment was conducted
• a level of care determination was made at the time of the assessment (or can be made by the nurse who conducted the assessment).

For updated information about the UAS-NY project, please visit the Department's website at: http://www.health.ny.gov/health_care/medicaid/redesign/uniform_assessment_system/

Please email any questions to "uasny@health.state.ny.us.